The TQM Magazine

Purpose – The core theme of this paper is that, to provide the best kind of process systems to support a “quality” healthcare provider, it is essential to “engineer-in” quality as early as possible – effectively at the specification and design phase. It extends to the healthcare context a novel approach, which provides a transparent model of how an envisioned structure delivers services and fulfils stakeholders' needs.

Design/methodology/approach – In the paper a new construct, developed by the authors, is described and then extended to the healthcare sector. The underpinning theories of the new construct are discussed and examples for a health care service are presented.

Findings – The paper finds that there is a full literature on quality and TQM, but relatively little offers practical tools for supporting design and implementation processes that enhance the likelihood of achieving quality operations. The presentation and discussion of the construct presented argue that the approach presented here can achieve this aim.

Practical implications – In the paper, as with many ventures, organisations charged with healthcare delivery are presently facing the dual challenges of seeking to satisfy widely extended stakeholder groups and implement complex ICT systems to support e-fulfilment. To ensure that quality is “engineered-in”, a holistic, integrated and quality approach is required, and Total Quality Management (TQM) principles are the obvious foundations for this.

Originality/value – The paper shows that electronically delivered information and funds transaction systems do offer healthcare organisations great potential, but many large integrated ICT systems have notoriously disappointed the stakeholder health care service. An integrative view of the delivery system design, based on the literature from strategic management, business process design, e-business design, and TQM, has yielded a unique construct, which integrates these views in a transparent model readily accessible to the various domain experts. The specific role of this in healthcare fulfilment system design applications is demonstrated.